Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Lens sphcy trifocal 4.0/.12-
Peoria, IL
See all hospitals reporting HCPCS V2303 →Price type
Proctor Community Hospital’s median price of $84 is 6% below the median hospital's median price ($90), higher than 26% of the 733 hospitals reporting HCPCS V2303. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 11 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $69 | $69 | — | — | — | $69 – $69 |
| 2 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 3 | Aetna medicare advantage case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 4 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 5 | Humana medicare advantage case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 6 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 7 | Molina medicare-medicaid (mmai/dual) case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 8 | UnitedHealthcare medicare advantage case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 9 | UnitedHealthcare va ccn case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 11 | UnitedHealthcare ppo fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
Last updated: Apr 15, 2026
See Trifocal eyeglass lens, per lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.